Each year, 13 million neonates are born prematurely (i.e., less than 37 weeks gestational age) worldwide. This number is growing due to medical and healthcare advances allowing premature neonates to survive and develop outside an in vivo uterine environment.
Premature neonates are at higher risk than neonates born full-term for neurodevelopmental disability at school age and adolescence. Premature neonates are also at higher risk of experiencing medical and social disabilities in adulthood. These risks are inversely related to gestational age and weight at birth. For neonates born extremely premature, impaired cognition and motor/neurosensory deficits occur frequently, can be severe, and can persist into school age and young adulthood.
Studies have shown that premature neonates can benefit from placement in a uterine-similar environment to optimize development (e.g., neurological or neuromuscular development), especially prior to reaching 37 weeks gestational age. Uterine simulation is associated with increased growth rates and reduced hospital stays.
Other studies have shown that all neonates, both premature and full-term babies, can benefit from proper post-birth positioning while neuromuscular mechanisms are in development. Proper positioning can result in neuromuscular benefits, including reduced crawling and walking delays, more efficient energy and oxygen expenditure, and increased core temperature.
In addition to a uterine-similar environment and proper post-birth positioning, another need for neonates is the treatment of hyperbilirubinemia. Bilirubin is a by-product of red blood cell replacement, which is a normal process within a healthy, functioning body. Bilirubin is converted to an excretable form by a properly functioning liver. If a liver hasn't yet matured fully or if red blood cell replacement is occurring at an excessive rate, excess bilirubin accumulates in the body. If bilirubin accumulation is sufficiently elevated, the neonate can become lethargic and hypotonic, which, without treatment, can cause hypertonia or fever. Hyperbilirubinemia can eventually result in cerebral palsy, hearing loss, dental dysplasia, gaze paralysis, or permanent intellectual or neurodevelopmental handicaps. Excess bilirubin results in a jaundiced, or yellowed, pigmentation of skin and mucosal membranes and, as such, this condition is commonly referred to as “jaundice.” It is estimated that mild jaundice occurs in approximately 60% of full-term neonates and approximately 80% of premature neonates. Severe jaundice is estimated to occur in approximately 7% of full-term neonates and approximately 50% of premature neonates.